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Federación Mexicana de Ginecología y Obstetricia, A.C.

2016, Número 11

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Ginecol Obstet Mex 2016; 84 (11)


Ganancia de peso durante el embarazo y resultados perinatales: estudio en una población española e influencia de las técnicas de reproducción asistida

Carmona-Ruiz IO, Saucedo-de la Llata E, Moraga-Sánchez MR, Cantero-Miñano MD, Romeu-Sarrió A

Idioma: Español
Referencias bibliográficas: 44
Paginas: 684-695
Archivo PDF: 332.37 Kb.


RESUMEN

Objetivo: comparar los resultados perinatales dependientes de la ganancia de peso de la madre durante el embarazo, diferenciando la proporción de mujeres con embarazo espontáneo versus mediante técnicas de reproducción asistida.
Material y Método: estudio descriptivo, observacional y retrospectivo llevado a cabo en mujeres embarazadas en control y atención del parto en una clínica privada de ginecología, obstetricia y reproducción asistida. Se excluyen las mujeres con enfermedades preexistentes que suponen un resultado perinatal adverso, además de embarazos gemelares o múltiples por el mal pronóstico perinatal asociado. Se utilizaron pruebas de Anova o Fisher y χ2 según el tipo de variable analizada.
Resultados: se analizaron 860 casos divididos en tres grupos según la ganancia de peso recomendada por el Instituto de Medicina: 1) menor ganancia; 2) ganancia igual a la recomendada y 3) ganancia mayor. Este último grupo tuvo resultados con diferencia estadísticamente significativa en relación con los otros. La proporción de cesáreas fue superior en los grupos 3 (66.6%) y 1 (34.3%) que la que permaneció en límites ideales (6.2%) (p ‹ 0.001). Ambos extremos en ganancia de peso tuvieron tasas superiores en la proporción de neonatos admitidos a la unidad de cuidados intensivos neonatales (24.9% en el grupo 1 y 19.2% en el grupo 3 versus 0.4% del grupo 2) (p‹0.001). La mayor ganancia de peso implicó una RM ajustada de 2.1 (IC95% 1.5-2.6) de tener algún resultado perinatal adverso. Ni la edad, el tabaquismo o las técnicas de reproducción asistida se asociaron con resultado perinatal adverso.
Conclusiones: tanto la baja como la excesiva ganancia de peso durante el embarazo implican alto riesgo de complicaciones perinatales para la madre y el feto. Es posible que las pacientes de reproducción asistida lleven mejor control previo a la concepción, con ventajas en estado nutricional y peso durante el embarazo.


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